Distillers Report C-212 - Texas

DISTILLER'S REPORT Monthly Report of Distilled Spirits Bottled, Received and Sold During the Month/Year of: **REPORT IS DUE ON OR BEFORE THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD** FORM C-212 (01/16) TABC USE ONLY ENTRY CHECKED TRADE NAME: ADDRESS: CITY: ZIP CODE: Distilled Spirits Summary of Taxes Due 1. 2. 3. 4. 5. 6. 7. 8. Beginning Bottled Inventory (Line 4 on Prior Monthly Report) Distilled Spirits Bottled (Page 2, Schedule A) Total Distilled Spirits Available (Line 1 + 2) Ending Bottled Inventory, End of Month Exemptions (Page 2, Schedule B) Total Distilled Spirits Exemptions (Line 4 + 5) Spirits Subject to Tax (Line 3 minus 6) Tax Rate 0 0 . 0 PERMIT NUMBER: EMAIL: PHONE NUMBER: Miniature 20-60ml (# of units) D Year-to-Date Totals (U.S. gallons) ( U.S. gallons) 0 0 0 $2.40 $0.05 *Gallonage reporting information is required in order to satisfy requirements in Chapters 14 of the Texas Alcoholic Beverage Code. 9. Sold for On-Premise Consumption 10. Spirits Sold for Off-Premise Consumption TABC USE ONLY 11. GROSS TAX DUE (Line 7 x Line 8) 12. LESS 2% (If payment received by due date) 13. LESS AUTHORIZED CREDITS 14. TAX DUE STATE $ $ - $ $ - $ - AFFIRMATION, Under penalty of perjury, I swear I am an officer or an authorized representative of the above Permittee, and I have examined this report, and confirm it is true, correct, and complete. Signature E-Mail Address Title Date INSTRUCTIONS: Prepare the report in duplicate, mail the original to the T.A.B.C., PO Box 13127, Austin, TX 78711-3127 on or before the 15th of the month, following the month for which the report is made. Retain one copy for you files for a period of four years. As long as your permit remains active, you must file a report even if no business was conducted. For assistance, please contact the Tax Division at (512) 206-3342 or excise.tax@tabc.texas.gov. Forms are available on our website at (www.tabc.state.tx.us). American LegalNet, Inc. www.FormsWorkFlow.com Page 1